Burns--risk factors and treatment

• Published in: הרפואה Vol. 148; no. 6; p. 375
• Main Authors: Perry, Zvi H, Palivatkel, Meirav, Yanculewitch, Noam, Koren, Lior, Rosenberg, Nir
• Format: Journal Article
• Language: Hebrew
• Published: Israel 01.06.2009
• Subjects: Body Surface Area; Burns - economics; Burns - epidemiology; Burns - mortality; Burns - therapy; Cost of Illness; Critical Care; Fluid Therapy; Humans; Israel - epidemiology; Morbidity; Risk Factors; United Kingdom - epidemiology; United States - epidemiology
• ISSN: 0017-7768

Burn injuries are very frequent and afflict approximately 1% of the population yearly. They are a source of heavy medical burden to medical systems worldwide. In the US alone, about 2 million burns are treated by medical staff yearly, and about 75,000 burns are serious enough to require hospitalization. In the UK, a similar situation is depicted in the statistics--burns constitute 1% of the ER workload, and 0.014% of the hospitalization. Morbidity and mortality from burns is mainly dependent upon: total body surface area (TBSA) that is involved in the burn, the depth of the burn and it's anatomical location, the age of the subject, prior medical history and the severity of adjacent injuries (especially pulmonological injury). TBSA is calculated by age-adjusted tables. There are a number of ways to determine this parameter, the simplest of all is called "the rule of 1/9". Using this technique we divide the body into distinct areas, each equal to 1/9 of the TBSA. The treatment of burn injuries is considered one of the most difficult in the medical profession and some even compare it to the treatment of ICU patients. The primary treatment in burns always involves the removal of the patient from the source of the thermal injury, securing his airway (especially in patients suspected of inhalation injury) and an aggressive fluid resuscitation. Fluid resuscitation is mainly managed using the Parkland equation. The treatment of the burned skin is by one of two regimes--the conservative regime (frequent redressing of the burn site, hygiene and antimicrobial treatment) and the surgical regime (early intervention with debridement, skin implantations etc.). Several different studies have shown a decrease in the mortality rate of severe burn patients who have undergone an early surgical regime in comparison to conservative treatment.